AUTHOR=Khuntia Hemant Kumar , Manna Prabir , Barik Deepak Kumar , Biswas Subhojeet , Bramha Prasanta Kumar , Pati Sanghamitra , Ranjit Manoranjan , Bal Madhusmita , Kerketta Anna Salomi 

TITLE=High prevalence of enterotoxigenic Escherichia coli strains in hospitalized diarrhea patients: a preliminary study from a cholera-endemic area in India (2022)

JOURNAL=Frontiers in Microbiology

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2025.1470783

DOI=10.3389/fmicb.2025.1470783

ISSN=1664-302X

ABSTRACT=IntroductionEnterotoxigenic Escherichia coli (ETEC), producing heat-stable (ST) and/or heat-labile (LT) enterotoxins, is a major cause of diarrhea in children and travelers in developing countries. Surveillance in cholera-endemic regions is crucial for timely public health response.MethodsBetween May and November 2022, a cross-sectional study was conducted in Puri, India. Rectal swabs from 256 hospitalized diarrhea patients were analyzed for diarrheagenic E. coli and Vibrio cholerae using microbiological and molecular methods. Antimicrobial susceptibility of ETEC isolates was also assessed.ResultsETEC was detected in 20.3% of cases, making it the most prevalent pathogen. No Vibrio cholerae was isolated. EAEC and EPEC were identified in 6.2% and 2.3% of cases, respectively. ETEC was significantly more common in children under 2 years (p < 0.00001), though overall age correlation was weak (R = –0.013). Symptoms included watery stool, vomiting, abdominal pain, and dehydration, with dehydration significantly associated with adults (p < 0.05). ETEC strains were susceptible to streptomycin, chloramphenicol, gentamicin, and amikacin.DiscussionETEC has emerged as the dominant diarrheal pathogen in a cholera-endemic area, posing a risk to both children and adults. These findings highlight the need for continued epidemiological monitoring and age-targeted interventions.